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Navy & Marine Corps Medical News
July 28, 2000
Navy and Marine Corps Medical News (MEDNEWS) is
a weekly compendium of news and information
contributed by commands throughout the Navy medical
department . Information contained in MEDNEWS stories
is not necessarily endorsed by Navy Bureau of
Medicine and Surgery (BUMED) , nor should it be
considered official Navy policy.
BUMED distributes MEDNEWS to Sailors and
Marines, their families, civilian employees and
retired Navy and Marine Corps families. Further
distribution is highly encouraged.
Stories in MEDNEWS use these abbreviations after
a Navy medical professional 's name to show
affiliation: MC - Medical Corps (physician) ; DC -
Dental Corps; NC — Nurse Corps; MSC - Medical Service
Corps (clinicians, researchers and administrative
managers) . Hospital Corpsmen (HM) and Dental
Technician (DT) designators are placed in front of
Contents for this week's MEDNEWS:
— DoD tests medical database for recruits
— Dental tech perfecting smiles on— board carrier
— Naval hospital enters e-commerce realm
— No one gets dogged when it comes to pet therapy
— NACC accreditation from College of American Pathologists
— History on display at Naval Hospital Bremerton
— Anthrax question and answer
— TRICARE question and answer
— Healthwatch: Car seat safety should take a back seat
Headline: DoD tests medical database for recruits
From Gulf link
WASHINGTON - Part of the reason it has been so
difficult to determine the causes of Gulf War
illnesses is a lack of complete pre— war medical
records for service members and veterans who have
developed symptoms . If a new medical program the
Department of Defense is testing proves successful,
that problem will not exist for future war fighters.
Doctors at the Naval Medical Research Center in
Bethesda, Md. , and the Naval Health Research Center
in San Diego, Calif. , are investigating the use of a
baseline medical database to evaluate the health of
military members and veterans. Capt. Kenneth Craig
Hyams, MC, said a working group of health
professionals from the departments of Defense,
Veterans Affairs and Health and Human Services has
been collaborating on this project together since
1996 to develop the Recruit Assessment Program.
"This is clearly one of the lessons learned from
our inability to answer Gulf War health questions. We
need greater baseline data to understand changes in
veterans ' conditions after they return from dangerous
deployments, " said Hyams.
In fact, lessons learned from the Gulf War
resulted in a complete review of doctrine, policy,
oversight and operational practices for force health
protection and military medical surveillance.
Surveillance in this case means gathering information
about both the health risks present in the
environment that our forces are deploying to and the
health status of service members. Hyams said that in
today's volatile world, surveillance shouldn't wait
until after the decision is made to send our forces
"Preparing for deployment can be an extremely
rushed and stressful time. It 's hard to get detailed
and accurate health data once troops begin preparing
for a potentially life threatening mission, " said
One way to avoid those pitfalls is to collect
baseline health data at recruitment and integrate
this data with health information collected
periodically during service members' careers. Such a
database would also help doctors understand service-
related medical problems from other causes of ill
health. Without a complete record of the health
status of recruits when they enter the military, it ' s
difficult to identify service related health hazards
— occupational and environmental risks — in the
Due to the need for improved health
surveillance , military planners want to create a
system to track and maintain medical information
about Soldiers, Sailors, Airmen and Marines
throughout their military careers. The first step
will be to gather health data as recruits enter the
service, including a complete medical history, family
history, occupational exposures and risk factors. The
RAP project will do just that with a RAP
questionnaire. That form, filled out by each recruit,
will establish a baseline health status for every
service member on initial entry.
"We're already implementing the RAP at the
Marine Corps Recruit Depot in San Diego and the Naval
Recruit Training Command in Great Lakes, Illinois, "
said Hyams . Future plans include testing the form at
the Air Force's Basic Military Training facility at
Lackland Air Force Base as well. Hyams said that the
RAP is not a major departure from current medical
Similar baseline information is already
collected from recruits on Standard Form 93 and
Standard Form 88, but their data is not
computerized, " he said.
The RAP, which is still being refined, is an
electronically scannable paper questionnaire which
recruits fill out during their first week of
training. A copy of the questionnaire will be added
to each service member's medical folder, while the
original is fed into a computerized database. That
process, when applied to more than 250, 000 incoming
recruits every year, will require the use of cutting
edge computer technology.
"We're testing a new generation of software and
hardware for rapid scanning of large amounts of
data," Hyams said. "That's being done at the Navy
Recruit Training Command in Great Lakes, 111 . , where
the concept of automated medical inprocessing of
recruits was pioneered in the SHIP program. "
If successful, the questionnaire will provide
accessible medical data to both DoD and VA doctors.
In future years it will be the beginnings of what is
called a longitudinal database, which allows a view
of active duty military and veterans ' health over
time. Linking the RAP with other DoD and VA health
records will create one of the world's largest
longitudinal databases. Longitudinal research allows
doctors to see trends in health problems in a
population. It will help the military medical
community better understand differences between
service members ' pre— and post— deployment health
He said the ability to see the long term changes
in an individual veteran's health will help military
and VA doctors make better diagnoses and offer better
Military planners believe that routine
collection of medical data from recruits could have a
substantial impact on health care and illness
prevention for military members and veterans. They
say both DoD and the VA would benefit from the
program by more accurately determining which health
problems are related to military service. And
questions about potentially harmful exposures during
military service could then be more quickly and
conclusively resolved, allowing for the development
of Liaproved prevention strategies .
Personnel from the departments of Defense,
Veterans Affairs and Human and Health Services are
working to make sure surveillance goals can be
realistically achieved for American troops and
veterans. Hyams sais they should have enough
information to make a recommendation concerning
whether or not the RAP should be implemented
throughout DoD sometime next year.
Headline: Dental tech perfecting smiles on— board
By JOl (AW) Kori Ahola
Aboard GEORGE WASHINGTON (CVN 73) - The sound of
a dentist's high-speed drill isn't the most relaxing
sound. With all of the advances made in the past 20
years in composite materials used to replace teeth,
there is no reason anyone on board can't have a set
of pearly whites they can smile about .
DT3 (AW) Jason Echada contributes to the smiles
on board USS GEORGE WASHINGTON. He works on
grinding, filing, buffing, sculpting and smoothing
"I use a lot of specialized equipment to get the
job done right the first time, " said Echada, the
ship's only prosthetics lab technician. "We have the
capability of doing everything from replacing a tooth
to creating multitooth bridges. I can even create
gold crowns for a Sailor if it 's required. "
Enchada works extensively with synthetic
substances, like white porcelain, that closely
resemble natural teeth.
"Replacing a tooth isn't just about aesthetics.
Having fully functional teeth is important to a
person's well being, " said Lt . Cmdr. Giacinto 'Jay'
Rubino, DC, the ship's dental prosthetics officer. "It
makes me feel good knowing that the crown or bridge
that I made will be around for a long time. "
Teeth are very individualistic and are as unique
as fingerprints. There's a lot of individual
workmanship and little room for error.
"When I 'm making a tooth, I try to make it
resemble the rest of the teeth in size, shape and
color. If I 'm even a millimeter off, a piece could
cause pain, " Echada said.
"You never know when a popcorn kernel is going
to ruin your day and break a tooth or some other
dental crisis may arise, " said Rubino. "We do good
dentistry and this is where it happens. "
Headline: Naval hospital enters e— commerce realm
By Judith Robertson, Naval Hospital Bremerton
BREMERTON, Wash. - An employee at the Naval
Hospital Bremerton was the second in Navy Medicine
community to be awarded for contributions to
'business-to-business electronic commerce. '
Judy Gitchell, lead purchasing agent and system
administrator for the Standard Procurement System was
presented with the Gary Thurston Product Integration
Award. This award is given to agents that are
leading the Navy's revolution in business affairs.
"I thank you for your positive contribution to
the implementation of the Standard Procurement System
and progress in achieving the goals of the Navy and
Marine Corps ' paperless acquisition procurement
process, " said Adm. G.H. Jenkins, Jr., Deputy for
Acquistion and Business Management, in a letter.
Years ago it was decided that there should be a
standardized procurement system within the Department
of Defense. The Navy started moving toward that goal
a few years ago and NH Bremerton followed in August
Gitchell guided her department at the hospital
through the overwhelming new system and acted as the
liaison with the hospital ' s Management Information
Department . She also spearheaded the regionalization
of procurement processes with Naval Hospital Oak
Harbor on Whidbey Island.
"It ties everyone together so we're paperless.
We used to spend hours at the copier, especially at
annual contract time. Now we can send the contracts
by email . It has just saved a lot of time for
everyone, " said Gitchell .
Headline: No one gets dogged when it comes to pet
By JOSN Theresa Raymond, Naval Hospital Portsmouth
Portsmouth, Va. - Dogs have always been
considered man ' s best friend. But at Naval Medical
Center Portsmouth they have become healing
The pet therapy program began in 1997 to comfort
patients during the healing process .
According to the 1992 Department of Defense
Human— Animal Bond Principles and Guidelines, the
first documented animal facilitated therapy program
in the United States occurred in 1942 at Pawling Air
Force Convalescent Center in New York. Dogs were
used to promote communication and convalescence .
Since then pet therapy and pet visitation
programs have been documented throughout the world in
inpatient hospital settings , community health
settings, prisons, psychiatric hospitals,
convalescent centers, rehabilitative centers and
Research has shown the effectiveness of pet
therapy in increasing communication and decreasing
the physical and emotional manifestations of anxiety.
According to the pet therapy program philosophy,
pet visitation lowers blood pressure and heart rate,
reduces the need for pain medication and provide
comfort by their presence .
The program responsibilities are divided among
four areas: the pet therapy committee, the health
care team, staff and documentation.
The combined efforts of each area ensures the
coordination and capability of requesting patients
Doctors verify that there are no known allergies
to animals or other problems associated with animals
where the pet therapy is taking place.
The base veterinarian must also certify the
animal for participation in the pet therapy program
by providing each animal with a Veterinary Health
Certificate, DD Form 2209.
Hospital sanitation is not compromised by this
alternative therapy. The staff ensures that owners
and handlers have their pets leashed or caged at all
times within the hospital. If the pet appears
unhealthy, poorly groomed, or ill behaved in any
manner, the staff has the right to refuse entrance
into the facility. Then they must notify the pet
therapy committee chairperson of the disbarment
within 72 hours.
Pet therapy is a feasible means of supplying
additional support and communication modalities for
patients and it is a unique and alternative way of
treatment that has extensive potential benefits to
patients as well as staff.
NMCP staff members have found innovative,
entertaining and enjoyable ways to holistically
address patient's needs.
Headline: NACC accreditation from College of American
From Naval Ambulatory Care Center Rhode Island
NEWPORT, R.I. - Naval Ambulatory Care Center
Rhode Island main laboratory was awarded
accreditation by the commission on laboratory
accreditation of the College of American Pathologists
June 30, following an on— site inspection. NACC's
main laboratory is one of the more than 6, 000 cap-
accredited laboratories nationwide.
The CAP laboratory accreditation program is
recognized by the federal government as being equally
as stringent as the government 's own inspection
Inspectors examine the records and quality
control of the laboratory for the preceding two
years, as well as the education and qualifications of
the total staff, the adequacy of the facilities, the
equipment, laboratory safety, and laboratory
management to determine how well the laboratory is
serving the patient .
The college of American pathologists is a
medical society serving nearly 16,000 physician
members and laboratory community throughout the
world. It is the world's largest association
composed exclusively of pathologists and is widely
considered the leader in laboratory quality
assurance . The CAP is an advocate for high— quality
and cost-effective medical care.
Headline: History on display at Naval Hospital
By Judith Robertson, Naval Hospital Bremerton Public
BREMERTON, Wash. - Bringing history to life was
the challenge Naval Hospital Bremerton 's First Class
Association recently took on as they assembled
pictures and information on all the commanding
officers involved in the delivery of Navy Medicine in
Puget Sound spanning three centuries.
Searching naval hospital archives throughout the
country, dusty pictures and yellowing biographies
were used in the construction of an informational and
photographic display of the 58 past commanding
officers who have led the Navy's healthcare providers
in the Puget Sound area since the 1800s.
Beginning with Ensign James Stroughton, Passed
Assistant Surgeon, who commanded the delivery of
medical care beginning in April 1895, to the present
Commanding Officer, Capt . Gregg Parker, MC, the "Hall
of History" reflects the changing emphasis on rank,
insignia, style of dress and uniforms over the years.
"Gathering history from the 1800s and early
1900s was an interesting learning experience, " said
HMl (FMF) Norberto Martinez, one of the coordinators.
The Hall of History was officially opened for
public display at a ribbon cutting June 20.
Headline: Anthrax question and answer
Question: How is anthrax diagnosed?
Answer: Anthrax is diagnosed by isolating the
bacteria. Bacillus anthracis, from the blood, skin,
or cerebral spinal fluid, or by measuring specific
antibodies in the blood of suspected cases.
Generally, diagnosis by antibodies is done weeks or
months after the infection occurs, too late to aid in
treatment . The best protection is vaccination before
exposure, combined with the appropriate Mission-
Oriented Protective Posture (MOPP) , including
protective clothing and detection equi^xnent .
Headline: TRICASE question and answer
Question: Is mental health and substance abuse
recovery covered under TRICARE Prime?
Answer: Mental health and substance abuse
treatments are covered under TRICARE Prime with a
minimal copayment. The cost for outpatient visits
will be $10 for E-4 and below and $20 for E-5 and
above. Retirees will pay $25 per visit. The
copayment s are reduced for group visits. For
inpatient care the costs are $20 per day for all
active duty family members and $40 per day for
Headline: Healthwatch: Car seat safety should take a
By Lt.j.g. Robyn Bent, U. S. Naval Hospital,
YOKOSUKA, Japan - Motor Vehicle crashes remain
the leading cause of accidental deaths in children
under the age of 14.
Yet proper use of a car seat can reduce the risk
of death for infants by 71 percent and for toddlers
by 54 percent . Unfortunately it is estimated that 85
percent of children in car seats and booster seats
are improperly restrained.
To do its job properly a car seat must be
installed securely against the vehicle's backseat.
If the car seat slides around on the seat, or if your
child slides around in the car seat, the child may
not be adequately protected.
To check for a tight fit push and pull on the
safety seat . If it moves more than one inch, you
need to tighten it . The seat should feel as though
it is part of the car. If the seat does not securely
fit in the car because the lap belt extends or
retracts, use the locking clip supplied with safety
Infants should ride in a rear-facing safety seat
until they are one-year-old and at least 20 pounds.
Studies show that what really protects the child in a
crash are their bones and it takes about a year for
the bones to harden enough to make the child safe in
a forward- facing seat .
The car seat should be positioned in the center
of the rear seat of the car, facing the back of the
car. The chest clip should be positioned at mid-
chest, armpit level. The shoulder straps should be
at the lowest slots for the newborn. The angle of
the seat should be about 45 degrees or about halfway
back in a semi-reclined position.
Forward-facing car seats should be used for
children who weigh 20—40 pounds. The seat should be
placed in the full upright position. The reclined
position used for the rear-facing seat does not
adequately protect a forward-facing child.
Booster seat are use for children who have
outgrown their car seats are not yet ready for using
grown-up seatbelts . If children are between 40-80
pounds they need a booster seat . Parents that use a
regular seatbelt for their children at this weight
run the risk of causing severe internal injuries in
the event of a crash or even an abrupt stop. This
happens when the seatbelt falls across the neck and
shoulders of the child causing neck injuries .
The booster seat literally boosts the child up
and positions the seatbelt so that the seatbelt fits
Parents should stop using car seats when the
child's legs are able to hang over the edge of the
seat touching the floor, and so that the shoulder
belt falls across the shoulders, not the neck. The
child should also be at least 8 years old so that the
hip bones are strong enough to absorb the impact of a
To find out more about car seat safety visit the
Safe Kids Coalition' s web site at www.safekids.org.
To find out if your car seat has been recalled
please check out www.nhtsa.dot.gov.
Comments about and ideas for MEDNEWS are welcome .
Story submissions are encouraged. Contact MEDNEWS
editor, at email: firstname.lastname@example.org; telephone
202-762-3218, (DSN) 762, or fax 202-762-3224 .